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BRIAN HOWARD CLARK PT

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1114063245

Individual Registrant:
 BRIAN HOWARD CLARK PT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1300 S MONTGOMERY AVE  SHEFFIELD, AL 35660-6334 US
Tel: 256-386-4005  Fax: 256-386-4685

Contact information for business:
2101 VIRGINIA AVE  MUSCLE SHOALS, AL 35661-2633 US
Tel: 256-314-0491  Fax: 256-386-4067

Registration Information:
NPI: 1114063245
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
ALPTH3211

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS51513137AL01




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